Vital infrastructure and operating theatres are becoming increasingly intelligent, with a plethora of complex technologies — from robotics, and 3D navigation and imaging, to artificial intelligence (AI) and augmented reality. Understanding how these technologies can be safely and effectively integrated and configured within the healthcare space is vital to improving patient outcomes, efficiency, and the future-proofing of healthcare facilities. This increasing complexity was a driver for Starkstrom’s recent investment in a new demonstration and training facility at its headquarters, to help stakeholders — such as clinicians, architects, healthcare estates personnel, and electrical and mechanical engineers — to plan and configure vital infrastructure and technology installations.
The Clinical Services Journal recently visited Starkstrom’s new state-of-the-art demonstration and training facility in Leicestershire — joining managing director, Guy Pomroy, for a guided tour. The company, which was first established in 1971, provides clinical infrastructure solutions to hospitals for critical care areas. In 1995, Starkstrom first introduced an isolated power supply to meet the impending IEC Directive, which required medical locations to meet stringent requirements for safe electrical provision. Today, the company’s portfolio has expanded to include a range of operating theatre lights, operating tables, and electrosurgery solutions, through to PACS viewing stations, theatre control panels, medical services pendants, and critical power solutions.
An interactive setting
Following the opening of the new demonstration and training facility, clinicians can now touch and interact with the latest advanced vital infrastructure and operating theatre technologies within a dedicated environment that showcases how these solutions can be integrated into the healthcare space to improve patient safety, advance surgery, enhance efficiency, and minimise vital infrastructure and theatre downtime. The technology demonstration facility also incorporates a training area for both staff and customers.
“Some of our best ‘showrooms’ are the hospitals where our vital infrastructure and operating theatre equipment has been installed — new customers can visit these facilities and see the technology in situ,” Guy Pomroy explained. “However, vital infrastructure and operating theatres are becoming increasingly complex, and we wanted to create a facility that would help clinicians make effective and informed decisions on how their technology could be configured. This includes aiding decisions on the accessories that they may want to connect to the pendants, the camera configurations on the operating theatre lights, and audio-visual equipment they may require.
“Within a week of opening the facility, we welcomed a number of clinicians and other stakeholders to it, and the feedback was really positive. They can be hands-on with the technology in an environment where it doesn’t matter if you make a mistake,” he continued.
Customer preferences
The facility has been created with a frame above the ceiling space that allows the room to be reconfigured at will, giving the flexibility to demonstrate and explore a variety of customer preferences for the vital infrastructure and operating theatre set-up — helping surgeons (as well as architects and electrical and engineering firms) to visualise a wide range of technology configurations in a realistic environment.
“The facility allows us to develop new innovations in a relatively live environment and evaluate how they might be received by clinicians,” Guy Pomroy added. “We also invest in continuous training for our staff and field engineers, and this state-of-the-art facility will help ensure the highest standards of technical support for healthcare providers that have installed our technologies.”
He further explained that some of the training courses are being recorded on video, and these will be shared via an online platform in the future. There will also be a programme of courses (currently being CPD accredited), and these will be made available via an ‘app’ and online, to facilitate flexible learning. This is in addition to the provision of in-person training.
“We have recently installed AEDs (defibrillators) and provided training to support this online,” Guy Pomroy explained. “We are now seeking to expand our training provision across other technology areas.”
During the tour of the facility, Guy Pomroy highlighted the company’s advanced picture archiving and communication system (PACS viewing station) and theatre control panels, which can be viewed and operated in the new live demonstration environment. The PACS technology — which provides access to images from multiple modalities, such as X-Ray, CT, MRI, and audio-visual equipment — can be designed to virtually any configuration to meet the theatre team’s needs and to help improve workflow in the operating theatre.
Humidity and temperature control
The touch-control panels enable the theatre team to control the humidity and temperature within the room, the functioning of the ultraclean canopy, keep track of the surgery duration (or how long the patient can be cooled in some procedures), and receive alerts relating to the power supply, for example.
Guy Pomroy also demonstrated the triangular Proteus pendant head — which has six surfaces that can be customised to meet an operating theatre’s needs. The pendants are designed to help with infection prevention practices, and improve workflow, by providing a safe and organised environment for clinical staff, and are easy to maintain and service. The pendant range includes provision for medical gas services (e.g. oxygen), an Anaesthetic Gas Scavenging System (AGSS) outlet to remove anaesthetic gases from the environment; and a VAC outlet to provide vacuum when used with suction control devices. This is in addition to provision for electrical services — such as electrical sockets, data points, TV aerial points, audio/visual sockets, and nurse call systems. Pendant movement is controlled by a remote switch or central membrane panel, making it easier to carry loads of up to 400 kg (e.g. monitors or anaesthetic machines). It also offers provision for cable management — so cables can be hidden away to help protect patients and clinical staff against trips and falls.
LED lighting provides gentle ambient light (side and up-lighting) and illumination for reading notes (down-lighting), while the pendants also offer provision for medical poles — with three integral 25 mm diameter IV poles and up to six Medi-Rails for mounting clinical devices and accessories, keeping the area around the patient bed tidy.
“We also have a channel for data — we are seeing a trend for more and more equipment, coupled with increased connectivity, in theatres, and this is only set to increase in the future,” Guy Pomroy commented.
Since 2004, Starkstrom has also been the exclusive UK distributor of KLS Martin operating lights, which include the marLED range. During the tour, Guy Pomroy demonstrated the latest generation in operating theatre lights — the new X-Series. He explained that these are among the most technically advanced lights available, and work on the philosophy of delivering the maximum level of lux at the coolest temperature possible. The new operating theatre light uses the latest generation LEDs — which are smaller, more compact, provide greater light efficiency, and use less power. Each one of the 96 LEDs can be actuated individually. Therefore, whatever the light intensity, luminous circular or oval field size, or colour temperature, the light provides numerous adjustments for the surgeon. This is in addition to fully automatic active shadow management, which ensures light is always available where it is needed for a clear view of the surgical field. The light has also been independently verified to be suitable for use under UCV canopies, and an HD camera can be integrated into the centre, to transmit video content to another location for surgical training purposes, or for archiving (a 4K option is available for higher definition). At the centre of the facility is an example of the company’s operating theatre tables — the OPT Vita, which Guy Pomroy described as being “built to last”.
Key insights into theatre builds and infrastructure
It is not just clinical visitors that are now benefiting from having access to the facility, however. Architects, for example, can understand not only what goes into the operating theatre, but also what goes in above the ceiling — this enables them to understand what steel structures are required to support the equipment, for example.
Mechanical and engineering companies can explore what will be required in terms of wiring for the operating theatre space, and the critical power infrastructure being installed. With operating theatre builds, the ability to gain these insights is key to successful planning and design.
On show at the facility is a range of technologies that are critical to ensuring high levels of electrical supply continuity and safety in operating theatres — including solutions for medical IT (IPS), battery back-up, and uninterruptible power supply (UPS).
In general, electrical safety can be compromised by either unplanned interruptions to supply (required for patients), or electric shock hazards (to patients and staff). It is recommended by several international and UK standards that medical IT (IPS) be used for circuits supplying medical electrical life-support equipment or in areas where intra-cardiac procedures are performed.
A medical IT system (IPS) is recommended over the standard TN Earthed Supply systems (the normal supply system for most industrial, commercial, and domestic applications), as it has several advantages, including the detection (via an alarm) of the insulation level of medical equipment dropping below pre-set parameters.
UPS systems are also a critical part of a hospital’s power supply infrastructure. When coupled with IPS systems and back-up generators, they provide the operating room and other critical care areas with continuity of power in the event of a supply failure. IEC 60364-7-710 and HTM 06-01 state that in the event of loss of power, all the medical locations where isolated power is installed (that is, “Group 2” and “Clinical Category 5” locations) require power to be resumed (for life supporting equipment) within a maximum of 0.5 seconds. The guidance further states that “Certain microprocessor-controlled equipment may require a no-break power supply”.
With a long history of working with its UPS partner, Power Control Limited, Starkstrom can provide a fully integrated package of a UPS system feeding into a medical IT (IPS) system, while the remote alarms for these systems can be integrated as a single remote alarm displayed on the Theatre Control Panel. By further integrating this within the Building Management System (BMS), email alerts can be sent across the hospital network.
Sustainability
Initiatives such as Green Theatres and the drive for sustainability in the NHS are also shaping the way operating theatre technologies are evolving. Guy Pomroy commented that Starkstrom is increasingly focusing on ensuring low power consumption. Operating theatres are recognised as energy ‘hotspots’, and are six times more energy-intense than hospitals as a whole,1 primarily due to heating, ventilation, and air-conditioning requirements. A paper by MacNeill et al has previously estimated that the carbon footprint of surgery in the three countries they studied was 9.7 million tonnes of CO2e per year.
However, another way that suppliers can improve sustainability is to ensure their technologies are long-lasting and reliable, so they are “not being replaced unnecessarily.”
Guy Pomroy highlighted the need for a shift to value-based procurement as part of a drive for greater sustainability, while future-proofing operating theatre technology is also important.
Infection prevention
It is widely recognised that the most sustainable surgical procedure is one that prevents surgical site infection. Infections increase the use of costly hospital resources, and lead to readmissions, repeat surgeries, and longer hospital stays. This is in addition to the human cost. Guy Pomroy commented that the company takes infection prevention extremely seriously, and it is at the heart of its R&D. “The coatings we use for our technologies are antimicrobial, and the surfaces of our technologies are designed to be easy to clean,” he explained. “This is a key focus area, and we are currently working with hospital IPC teams on the development of future products that will advance this further.”
One of the latest developments, launched by Starkstrom at the Infection Prevention Society’s annual conference and exhibition, is one of the most advanced UV-C disinfection robots available in the healthcare sector. The Omnia combines robotics with advanced AI and UV-C disinfection technology, to provide efficient disinfection. Equipped with advanced sensors and intelligent mapping, the robot autonomously plans its routes, avoids obstacles, and operates independently, freeing up staff for more critical tasks. The compact, slim design allows it to navigate tight spaces and reach areas often overlooked by traditional cleaning methods.
Thorough exposure to UV-C light
The ability to approach obstacles down to just 15 cm ensures that even the most challenging areas receive thorough exposure to UV-C light, effectively destroying bacteria, viruses, and other harmful pathogens. In addition, the robot automatically shuts off its UV-C lamps if it detects any human presence within the disinfection area, preventing accidental exposure.
“In today’s healthcare landscape, where patient safety and hygiene are critical, the Omnia UV-C Disinfection Robot sets a new benchmark in autonomous disinfection. This innovative solution is designed with precision, efficiency, and reliability in mind, utilising powerful UV-C light to effectively eliminate pathogens,” Guy Pomroy commented. “The Omnia ensures a sterile environment across all hospital areas, including those that are challenging to sanitise with traditional methods. With healthcare-associated infections (HCAIs) affecting 7-10% of patients, and often leading to prolonged hospital stays of up to 14 days, the Omnia offers a powerful tool to reduce these risks. By minimising HCAIs, it not only helps shorten patient stays and free up hospital beds, but also enhances overall safety for both patients and staff. Beyond infection prevention, the Omnia contributes to a safer work environment by reducing the presence of harmful pathogens and combatting the rise of antimicrobial resistance (AMR),” he continued.
The future operating theatre
When asked about the innovations we can expect to see in the future, Guy Pomroy further expanded that there has been a lot of interest and discussion around artificial intelligence — including ChatGPT.
“Machine learning has been around for a while, and we can clearly see a lot of products are coming into the theatre, so we must make provision for this. We also know that there is a drive towards augmented reality for surgeons. In the future, surgeons will view images superimposed over the patient, instead of having to view a PACS screen, for example. Therefore, pendants will need to accommodate these new technologies and approaches,” he commented.
Looking to the future, Guy Pomroy predicts that advances in laparoscopic and endoscopic procedures will continue to assist with reducing operating time and produce safer outcomes, while we will also see the advancement of ‘smart’ hospitals, integrating care with more digital input.
“The reduction of HCAI will be a key to safety and patient care, and we will also see more surgical hubs formed with ‘barn’ style environments, and more community-based hubs,” he concluded. “Starkstrom is already taking steps forward with the future vision for the operating theatre. We are constantly improving and innovating and introducing products such as Omnia, continuously working with clinicians to help solve problems today, as well as future-proofing their working environments.”
Acknowledgement
- This article, titled ‘Hands-on facility showcases latest innovation’, first appeared in the January 2025 edition of The Clinical Services Journal. HEJ acknowledges the help of its author, CSJ’s editor, Louise Frampton, and Starkstrom, in allowing its re-publication here.
Reference
1 Cited by the Centre for Sustainable Healthcare. Original source: MacNeill AJ, Lillywhite R, Brown CJ. The impact of surgery on global climate: a carbon footprinting study of operating theatres in three health systems. Lancet Planet Health. 2017 Dec;1(9):e381-e388. doi: 10.1016/S2542-5196(17)30162-6. Epub 2017 Dec 8. PMID: 29851650.